非小细胞肺癌肝转移的危险因素分析及不同疗法的比较

王森; 魏元东; 赵智毅; 王胜军; 彭伟; 丁强; 郝吉庆

doi:10.16462/j.cnki.zhjbkz.2016.09.019

非小细胞肺癌肝转移的危险因素分析及不同疗法的比较

doi: 10.16462/j.cnki.zhjbkz.2016.09.019

1. 安徽省第二人民医院介入科, 安徽合肥 230041;
2. 安徽省第二人民医院黄山路院区肿瘤内科, 安徽合肥 230041;
3. 安徽省第二人民医院黄山路院区普外科, 安徽合肥 230041;
4. 安徽医科大学第一附属医院肿瘤内科, 安徽合肥 230022

基金项目:

安徽省自然科学基金计划项目（1308085MH142）；安徽省对外科技合作计划项目（1503062023）

详细信息

作者简介:
王森(1985-),男,安徽宿州人,医师,在读硕士研究生。主要研究方向:肿瘤介入治疗。

中图分类号: R734.2;R181
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出版历程
- 收稿日期: 2016-03-18
- 修回日期: 2016-05-19

An analysis of risk factors of liver metastases from non-small cell lung cancer and a comparison of different treatments for it

1. Department of Intervention, the Second People's Hospital of Anhui Province, Hefei 230041, China;
2. Department of Oncology, the Huangshan Road Branch of Second People's Hospital of Anhui Province, Hefei 230041, China;
3. Department of General Surgery, the Huangshan Road Branch of Second People's Hospital of Anhui Province, Hefei 230041, China;
4. Department of Oncology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China

摘要

摘要: 目的探讨非小细胞肺癌发生肝转移的危险因素；发生肝转移后采用手术、单纯全身化疗、全身化疗联合肝动脉化疗栓塞三种疗法治疗效果比较。方法经查阅文献筛选出可能与非小细胞肺癌（non-small cell lung cancer，NSCLC）肝转移有关的危险因素，采用χ²检验初步探索与肝转移相关的危险因素，进而采用多因素Logistic回归分析深入研究非小细胞肺癌肝转移的独立危险因素。采用Kaplan-Meier生存曲线比较三种疗法各自的预后，通过比较各自的无进展生存判断各疗法的优劣。结果无乙肝病史（P<0.001）、病理类型为腺癌（P=0.004）、分期为Ⅲ期（P<0.001）为非小细胞肺癌肝转移的独立危险因素。联合组有效率（65.0%）高于化疗组（31.0%）（χ²=10.037，P=0.002）。联合组中位无进展生存（7.9个月）长于化疗组（6.3个月）（χ²=2.561，P=0.001）及手术组（5.9个月）（χ²=3.762，P=0.007），手术组与化疗间差异无统计学意义（χ²=0.540，P=0.462）。结论无乙肝病史、腺癌、Ⅲ期为非小细胞肺癌肝转移的独立危险因素。肝转移后手术短期疗效佳，长期疗效与化疗相似，劣于化疗联合介入。
- 癌,非小细胞肺 /
- 外科手术 /
- 抗肿瘤联合化疗方案
Abstract: Objective To explore the risk factors of liver metastases from non-small cell lung cancer (NSCLC) and to compare the advantages and limits of surgery, chemotherapy and chemotherapy combined with transcatheter arterial chemoembolization (TACE) in treating the liver metastases from NSCLC. Methods We reviewed literature to find potential risk factors that could affect liver metastases from NSCLC. Next, they were investigated using the chi-square test and logistic regression analysis. Also, Kplan-Meier survival curve analysis was used to compare the three kinds of treatments. Results Chi-square test and logistic regression analysis suggested that no history of hepatitis B (P<0.001), adenocarcinoma (P=0.004) and stage Ⅲ (P<0.001) were independent prognostic factors. The efficiency rate was 100% for surgery, 31.0% for chemotherapy and 65.0% for chemotherapy combined with TACE (CCT), respectively (χ²=10.037, P=0.002). The median PFS was 6.3 months for surgery, 5.9 months for chemotherapy and 7.9 months for CCIT, respectively (surgery vs chemotherapy: χ²=0.540, P=0.462; CCT vs chemotherapy: χ²=2.561, P=0.001; CCT vs surgery: χ²=3.762, P=0.007). Conclusions No history of hepatitis B, adenocarcinoma and stage III are risk factors of liver metastases from NSCLC. CCT may bring more PFS benefits compared with surgery and chemotherapy for patients with liver metastases from NSCLC.
- Carcinoma, non-small-cell lung /
- Surgical procedures, operative /
- Antineoplastic combined chemotherapy protocols

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参考文献(14)

Matt L, Sehgal R. Metastatic non-small-cell lung cancer to the liver and pancreas [J]. Gastrointest Cancer, 2014,7(2):61-62.

Castañón E, Rolfo C, Viñal D, et al. Impact of epidermal growth factor receptor (EGFR) activating mutations and their targeted treatment in the prognosis of stage IV non-small cell lung cancer (NSCLC) patients harboring liver metastasis [J]. J Transl Med, 2015,13:257.

李静,潘跃银,张颖. 索拉菲尼对EGFR及K-ras基因突变肺癌细胞株的增殖抑制作用及其作用机制 [J]. 安徽医科大学学报, 2013,48(3):220-223.

Yano T, Yokoyama H, Fukuyama Y, et al. The current status of postoperative complications and risk factors after a pulmonary resection for primary lung cancer. A multivariate analysis [J]. Eur J Cardiothorac Surg, 1997,11(3):445-449.

Ueda J, Yoshida H, Mamada Y, et al. Surgical resection of solitary metastatic liver tumor arising from lung cancer: a case series [J]. Hepatogastroenterology, 2012,59(119):2307-2309.

高月霞,黄彬鋆,吴桂云,等. 610例Ⅲ、Ⅳ期非小细胞肺癌患者预后生存分析 [J]. 中华疾病控制杂志, 2015,19(1):74-77.

Riihimäki M, Hemminki A, Fallah M, et al. Metastatic sites and survival in lung cancer [J]. Lung Cancer, 2014,86(1):78-84.

Utsunomiya T, Saltsu H, Saku M, et al. Rare occurrence of colorectal cancer metastasis in livers infected with hepatitis B or C virus [J]. Am J Surg, 1999,177(4):279-281.

高飞,贾霖,杜小波,等. 非小细胞肺癌肝转移与乙肝病毒感染关系 [J]. 齐齐哈尔医学院学报, 2012,33(19):2591-2592.

Nagashima A, Abe Y, Yamada S, et al. Long-term survival after surgical resection of liver metastasis from lung cancer [J]. Jpn J Thorac Cardiovasc Surg, 2004,52(6):311-313.

Xiao HQ, Tian RH, Zhang ZH, et al. Efficacy of pemetrexed plus platinum doublet chemotherapy as first-line treatment for advanced nonsquamous non-small-cell-lung cancer: a systematic review and meta-analysis [J]. Onco Targets Ther, 2016,9:1471-1476.

Noonan KL, Ho C, Laskin J, et al. The influence of the evolution of first-line chemotherapy on steadily improving survival in advanced non-small-cell lung cancer clinical trials [J]. J Thorac Oncol, 2015,10(11):1523-1531.

梁宁震,周怡萍,肖莉,等. 恩度联合GP 方案治疗晚期非小细胞肺癌肝转移疗效观察 [J]. 中国医科大学学报, 2011,40(10):954-955.

贺光辉,高洪盛,陈鲁青,等. 肺癌肝转移24例介入治疗临床分析 [J]. 中国临床新医学, 2012,5(1):25-27.

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